Design changes in the latest versions of a St. Jude Medical heart device failed to stem potentially life-threatening problems that plagued earlier, recalled versions of the product, according to a study published online Tuesday in the medical journal Europace.

Just as the dust appeared to be settling from St. Jude Medical Inc.’s months-long saga over a troubled heart-device, U.S. regulators sent a warning shot that could rattle doctors and patients.

The agency advised doctors to begin routinely screening the nearly 80,000 U.S. patients who have Riata defibrillator leads in their chests with X-rays to search for signs that a device’s insulation is wearing away. FDA officials also pressed the company to amp up studies for both the flawed Riata device and its successor, Durata-series leads, which have not yet been linked to problems.

Are You Mom Enough? (Time): Featuring a provocative cover photo of a mother breast-feeding her three-year-old child, the magazine explores attachment parenting. Its three main tenets are extended breast-feeding, co-sleeping and “baby wearing,” in which infants are physically attached to their parents by slings.

Justices Question Health Law (WSJ): The Supreme Court’s conservative justices sharply challenged the Obama administration’s health-care overhaul Tuesday, raising the prospect that the law could be struck down, while the liberal and conservative wings seemed inclined to split evenly over the question of whether the “individual mandate” is constitutional.

More Mesh Studies: An FDA advisory panel yesterday backed plans by the agency to require pre-approval studies for new surgical-mesh products inserted transvaginally to treat pelvic-organ prolapse as well as to conduct research on products already on the market, the WSJ reports. The products, whose manufacturers include Johnson & Johnson and Boston Scientific, currently can be approved without any new research, but the safety of transvaginal mesh for organ prolapse has come into question amidst more than 1,500 reports of adverse events between 2008 and 2010 …

Mesh in the Spotlight: An FDA advisory panel meets today to consider whether surgical mesh inserted vaginally to treat pelvic-organ prolapse should face tighter regulation, the WSJ reports. The FDA received about 1,500 reports of adverse events and seven deaths associated with the transvaginal use of the mesh for prolapse. Manufacturers including Johnson & Johnson and Boston Scientific, which face a spate of lawsuits over the products, say they don’t need to be bumped up to the Class III high-risk category, which would entail additional testing for existing products and a longer road to approval for new products …

You’re used to treating patients with a particular malady one way, but then a new technology comes on the market. It’s unproven, but seems promising. So what do you do for your patients — rely on the old way, or add the new …

Money-Saving Opportunity?: A new report by the inspector general of the Department of Health and Human Services says the Medicare program could have saved more than $1 billion over two years if Genentech’s cancer drug Avastin had been prescribed off-label for wet macular degeneration rather than Lucentis, the company’s similar, costlier drug that is approved for the eye condition, the WSJ reports. Medicare patients themselves could have saved an additional $275 million, according to the report. The off-label use of Avastin was recently been linked to eye infections when pharmacies separated large doses into single-use syringes …

Tracking Implants: An FDA official said silicone breast implants made by Johnson & Johnson’s Mentor and Allergan will stay on the market, and that the agency will work with the companies to increase participation in post-approval studies, Dow Jones Newswires reports. Companies have struggled to maintain follow-up on the 80,000-plus women originally included in those studies, originally planned to last a decade, with Allergan tracking about 60.5% of them for two years and Mentor following 21% for three years. If more women aren’t tracked, the studies won’t be able to detect possible long-term health issues …

Linking Financial and Physical Health: New research published by the National Bureau of Economic Research suggests higher foreclosure rates are associated with increased ER visits and hospitalizations for hypertension, diabetes and anxiety among 20- to 49-year-olds in several states, the WSJ reports. It’s unclear whether foreclosure itself is responsible for an increase in stress-related health problems or whether the underlying problem is financial duress or something else, the paper says …

Men and Women, Sleeping: Men and women sleep differently, with women experiencing deeper sleep, waking up fewer times during the night, and tolerating a lack of shut-eye better than men — even as men report greater overall satisfaction with their sleeping patterns, the WSJ reports. Research into gender and sleep differences may help explain the generally better health status of women compared to men, the paper says …

A heart pump for kids awaiting a transplant appears headed for approval at the FDA, as the WSJ reports. It would help fill a void for lot of children hit by diseases usually associated with adults: the lack of kid-friendly devices to help in their care.

The Berlin Heart can help keep kids’ hearts beating for several months if necessary until a donor organ can be found, much longer than a last-ditch heart-lung machine called ECMO that doctors sometimes use in such circumstances ..

Medical-device regulation is a tricky balancing act. Consumer advocates say the current process doesn’t ensure the safety and efficacy of devices on the market, while the device industry says the FDA’s process is inefficient and expensive and keeps products from reaching patients in need.

Choosing a Spinoff: Pfizer is more likely to spin off its animal health division than to sell it, the WSJ reports, citing people familiar with the matter. The pharma company is still likely to entertain offers for the business, which could be worth as much as $15 billion, but tax and antitrust considerations make it unlikely it will opt for a sale and will instead prepare to spin it off, the paper says …

Inadvisable Use?: Pricey heart devices used in cardiac resynchronization therapy may not help 38% of the patients for whom they’re currently indicated, the WSJ reports, citing a study published online by the Archives of Internal Medicine. The devices — whose makers include Medtronic, St. Jude and Boston Scientific — help synchronize the contraction of the left and right ventricles, but a subset of patients don’t seem to receive any benefit. The president of the Heart Rhythm Society says the study isn’t enough to change current practice guidelines …

The Profit Motive: With the health-care overhaul law requiring insurers to spend more on medical care, companies are pushing into new lines of business in pursuit of profits, the WSJ reports. Aetna, Humana and WellPoint are looking at health-care IT, partnerships allowing them to employ physicians and participation in the accountable care organizations encouraged by the health law, the paper says …

Johnson & Johnson, which has grown into a health-care powerhouse by acquiring small firms, is no stranger to making deals. But it’s never done anything as big as the one announced today, for device-maker Synthes. That could make digesting the new business thorny, even for a company as adept as J&J. The $21.3 billion takeover of the surgical-device maker will be J&J’s biggest, eclipsing its $16.6 billion purchase of Pfizer’s consumer business in 2006 …

Medical-technology company Synthes has confirmed it’s in talks with Johnson & Johnson about being taken over by the U.S.-based health-care behemoth. (Sources tell the WSJ the deal could be worth at about $20 billion.)